CHAPTER 36 BOARD OF NURSING
SECTION .0100 GENERAL PROVISIONS
21 NCAC 36 .0101LOCATION
History Note:Authority G.S. 90171.23(b)(3);
Eff. February 1, 1976;
Amended Eff. January 1, 1984;
Repealed Eff. January 1, 1986.
21 NCAC 36 .0102FUNCTIONS
History Note:Authority G.S. 90171.23(b)
Eff. February 1, 1976;
Amended Eff. January 1, 1983;
Repealed Eff. April 1, 1989.
21 NCAC 36 .0103ORGANIZATION
History Note:Authority G.S. 90159(2); 90162;
Eff. February 1, 1976;
Repealed Eff. January 1, 1983.
21 NCAC 36 .0104OFFICERS
21 NCAC 36 .0105COMMITTEES
21 NCAC 36 .0106EXECUTIVE DIRECTOR
21 NCAC 36 .0107SEAL
History Note:Authority G.S. 90171.22; 90171.23(b)(3),(4),(14); 90171.24;
Eff. February 1, 1976;
Amended Eff. November 1, 1984; January 1, 1984; January 1, 1983;
Repealed Eff. January 1, 1986.
21 NCAC 36 .0108PROCEDURE FOR ADOPTION OF RULES
History Note:Authority G.S. 90162;
Eff. February 1, 1976;
Repealed Eff. January 1, 1983.
21 ncac 36 .0109SELECTION AND QUALIFICATIONS OF NURSE MEMBERS
(a) Vacancies in nurse member positions on the Board that are scheduled to occur during the next year shall be announced in the last issue of the North Carolina Board of Nursing "Bulletin" for the calendar year, which shall be mailed to the address on record for each North Carolina licensed nurse and posted on the Board's website at The "Bulletin" and website shall include a petition form for nominating a nurse to the Board and information on filing the petition with the Board.
(b) Each petition shall be checked with the records of the Board to validate that the nominee and each petitioner holds a current North Carolina license to practice nursing. If the nominee is not currently licensed, the petition shall be declared invalid. If any petitioners are not currently licensed and this decreases the number of petitioners to less than 10, the petition shall be declared invalid.
(c) On forms provided by the Board, each nominee shall:
(1)indicate the category for which the nominee is seeking election;
(2)attest to meeting the qualifications specified in G.S. 90-171.21(d);
(3)provide written permission to be listed on theballot; and
(4)complete the Application for Boards and Commissions in accordance with Governor Perdue's Executive Order 55.
The forms must be received by the Board or postmarked on or before April 15.
(d) Minimum on-going employment requirements for the registered nurse or licensed practical nurse member shall include continuous employment equal to or greater than 50% of a full-time position that meets the criteria for the specified Board member position.
(e) This Paragraph applies in determining qualifications for registered nurse categories of membership:
(1)Nurse Educator includes any nurse who teaches in or directs a Board approved nursing program in the specific category as outlined in G.S. 90-171.21(d).
(2)Hospital is defined as any facility which has an organized medical staff and which is designed, used, and primarily operated to provide health care, diagnostic and therapeutic services, and continuous nursing services to inpatients, but excludes nursing homes and adult care homes.
(3)A hospital system is defined as a multihospital system, or a single diversified hospital system that includes a hospital as defined in Subparagraph (e)(2) of this Rule plus non-hospital preacute and postacute client services.
(4)A nurse accountable for the administration of nursing services shall be the chief nurse executive of a hospital, hospital system, or the director of nursing services for a service division that includes inpatient care within a hospital or hospital system.
(5)A nurse practitioner, nurse anesthetist, nurse midwife or clinical nurse specialist includes any advanced practice registered nurse who meets the criteria specified in G.S. 90-171.21(d)(4).
(f) The term "nursing practice" when used in determining qualifications for registered or practical nurse categories of membership, means any position for which the holder of the position is required to hold a current license to practice nursing at the appropriate licensure level for each category.
(g) A nominee shall be listed in only one category on the ballot.
(h) Separate slates shall be prepared for election of registered nurse nominees and for election of licensed practical nurse nominees. Nominees shall be listed in random order on the slate for licensed practical nurse nominees and within the categories for registered nurse nominees. Slates shall be published in the "Bulletin" and posted to the Board website following the Spring Board meeting and shall be accompanied by biographical data on nominees and a passport-type photograph.
(i) The procedure for voting shall be identified in the "Bulletin" following the Spring Board meeting.
(j) The Board of Nursing may contract with a computer or other service to receive the votes and tabulate the results.
(k) The tabulation and verification of the tabulation of votes shall include the following:
(1)The certificate number shall be provided for each individual voting; and
(2)The certificate number shall be matched with the database from the Board.
(l) A plurality vote shall elect. If more than one person is to be elected in a category, the plurality vote shall be in descending order until the required number has been elected. In any election, if there is a tie vote between nominees, the tie shall be resolved by a draw from the names of nominees who have tied.
(m) The results of an election shall be recorded in the minutes of the next regular meeting of the Board of Nursing following the election and shall include at least the following:
(1)the number of nurses eligible to vote;
(2)the number of votes cast; and
(3)the number of votes cast for each person on the slate.
(n) The results of the election shall be forwarded to the Governor and the Governor shall commission those elected to the Board of Nursing.
(o) All petitions to nominate a nurse, signed consents to appear on the slate, verifications of qualifications, and copies of the computerized validation and tabulation shall be retained for a period of three months following the close of an election.
History Note:Authority G.S. 90-171.21; 90-171.23(b);
Eff. May 1, 1982;
Amended Eff. August 1, 1998; January 1, 1996; June 1, 1992; March 1, 1990; April 1, 1989;
Temporary Amendment Eff. July 2, 2001;
Amended Eff. December 1, 2010; November 1, 2008; January 1, 2004; August 1, 2002.
21 NCAC 36 .0110OPEN MEETINGS
History Note:Authority G.S. 90171.23(a); 143318.10;
Eff. January 1, 1983;
Amended Eff. May 1, 1988; July 1, 1984;
Expired Eff. February 1, 2018 pursuant to G.S. 150B-21.3A.
21 NCAC 36 .0111REMOVAL OF BOARD MEMBERS
History Note:Authority G.S. 90171.21(f);
Eff. January 1, 1983;
Repealed Eff. January 1, 1986.
21 NCAC 36 .0112DETERMINATION OF VACANCY
(a) Except for the RN At-Large Member, should a licensed nurse member of the Board cease to meet the employment criteria as defined in G.S. 90-171.21(d) and Rule .0109 Paragraphs (d) and (e)of this Section, the member shall have 60 days to resume employment in the designated area. If employment criteria for the specified area are not met within 60 days, the seat shall be declared vacant. Provided, however, that if such a change in employment for the specified category of Board member occurs within 18 months of the end of the member's term, such member may continue to serve until the end of the term.
(b) If at any time a registered nurse member no longer meets the eligibility requirements listed in G.S. 90-171.21(d)(1)(a) and (a1), such member shall no longer continue to serve and the position shall be declared vacant.
(c) If at any time a licensed practical nurse member no longer meets the eligibility requirements listed in G.S. 90-171.21(d)(2)(a) and (a1), such member shall no longer continue to serve and the position shall be declared vacant.
(d) Any vacancy of an unexpired term shall be filled according to G.S. 90-171.21(c).
History Note:Authority G.S. 90171.21(c); 90171.23(b);
Eff. May 1, 1988;
Amended Eff. November 1, 2008; January 1, 2004; August 1, 2002; March 1, 1990; May 1, 1989.
21 NCAC 36 .0113DETERMINATION OF QUALIFICATIONS
For purposes of G.S. 90171.21 and Rule .0109(d) and (e) of this Section, the Board shall determine whether a person meets the employment requirements by examining the following factors:
(1)whether the licensee is presently employed equal to or greater than 50% of a full-time position;
(2)the number of days during the preceding three years devoted to practice in the specified activity that would qualify the licensee for election in that category;
(3)the duration of any periods of interruption of engaging in the specified activity during the preceding three years and the reasons for any such interruptions;
(4)job descriptions, contracts, and any other relevant evidence concerning the time, effort, and education devoted to the specified activity; and
(5)whether engagement in the specified activity is or has been for compensation, and whether income from the specified activity meets the eligibility requirements for the specified nurse member category.
History NoteAuthority G.S. 90171.21(d); 90171.23(b)(2);
Eff. May 1, 1988;
Amended Eff. January 1, 2004; August 1, 2002; May 1, 1989.
21 NCAC 36 .0114reserved for future codification
21 NCAC 36 .0115Reserved for future codification
21 NCAC 36 .0116Reserved for future codification
21 NCAC 36 .0117reserved for future codification
21 NCAC 36 .0118reserved for future codification
21 NCAC 36 .0119reserved for future codification
21 NCAC 36 .0119SUSPENSION OF AUTHORITY TO EXPEND FUNDS
In the event the Board's authority to expend funds is suspended pursuant to G.S. 93B-2(d) the board shall continue to issue and renew licenses and all fees tendered shall be placed in an escrow account maintained by the Board for this purpose.Once the Board's authority is restored, the funds shall be moved from the escrow account into the general operating account.
History Note:Authority G.S. 93B-2;
Eff. December 1, 2010;
Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 9, 2018.
21 NCAC 36 .0120DEFINITIONS
The following definitions apply throughout this chapter unless the context indicates otherwise:
(1)"Administrative Law Counsel" means an attorney whom the Board of Nursing has retained to serve as procedural officer for contested cases.
(2)"Academic term" means one semester of a school year.
(3)"Accountability/Responsibility" means being answerable for action or inaction of self, and of others in the context of delegation or assignment.
(4)"Accredited institution" means an institution accredited by a United States Department of Education approved institutional accrediting body.
(5)"Active Practice" means activities that are performed, either for compensation or without compensation, consistent with the scope of practice for each level of licensee as defined in G.S. 90-171.20(4), (7), and (8).
(6)"Advanced Practice Registered Nurse (APRN)" means a nurse practitioner, nurse anesthetist, nurse-midwife or clinical nurse specialist.
(7)"Assigning" means designating responsibility for implementation of a specific activity or set of activities to a person licensed and competent to perform such activities.
(8)"Clinical experience" means application of nursing knowledge in demonstrating clinical judgment in a current or evolving practice setting where the student provides care to clients under the supervision of faculty or a preceptor.
(9)"Clinical judgment" means the application of the nursing knowledge, skills, abilities, and experience in making decisions about client care.
(10)"Competent" means having the knowledge, skills, and ability to safely perform an activity or role.
(11)"Continuing Competence" means the on-going acquisition and application of knowledge and the decision-making, psychomotor, and interpersonal skills expected of the licensed nurse resulting in nursing care that contributes to the health and welfare of clients served.
(12)"Contact Hour" means 60 minutes of an organized learning experience.
(13)"Continuing Education Activity" means a planned, organized learning experience that is related to the practice of nursing or contributes to the competency of a nurse as outlined in 21 NCAC 36 .0223 Subparagraph (a)(2).
(14)"Controlling institution" means the degree-granting organization or hospital under which the nursing education program is operating.
(15)"Curriculum" means an organized system of teaching and learning activities directed toward the achievement of specified learning objectives and outcomes.
(16)"Delegation" means transferring to a competent individual the authority to perform a selected nursing activity in a selected situation. The nurse retains accountability/responsibility for the delegation.
(17)"Debriefing" means an activity that follows a clinical or simulated experience and is led by a trained faculty facilitator. Students' reflective thinking is encouraged, and feedback is provided regarding the students' performance during discussion of various aspects of the completed experiences.
(18)"Dimensions of Practice" means those aspects of nursing practice that include professional responsibility, knowledge-based practice, ethical and legalpractice, and collaborating with others, consistent with G.S. 90-171.20(4), (7), and (8).
(19)"Distance education" means teaching and learning strategies used to meet the learning needs of students when the students and faculty are not in the same location.
(20)"External standardized examination" means a commercially available standardized predictive test that provides individual student scores that are linked to a probability of passing the NCLEX™ examination.
(21)"Faculty directed clinical practice" means clinical experiences provided under the accountability/responsibility and direction ofnursing program faculty.
(22)"Focused client care experience" means a clinical experience that emulates an entry-level work experience in nursing. The intent is to assist the student to transition to an entry-level nursing practice. There is no specific setting requirement. Supervision may be by faculty and preceptor dyad or direct faculty supervision.
(23)"Interdisciplinary faculty" means faculty from professions other than nursing.
(24)"Interdisciplinary team" means all individuals involved in providing a client's care who cooperate, collaborate, communicate, and integrate care to ensure that care is continuous and reliable.
(25)"Learning resources" means materials that faculty use to assist students in meeting the expectations for learning defined by the curriculum.
(26)"Level of Licensure" means practice of nursing by either a Licensed Practical Nurse or a Registered Nurse as defined in G.S. 90-171.20(7) and (8).
(27)"Level of student" means the point in the program to which the student has progressed.
(28)"Maximum enrollment" means the total number of pre-licensure students that can be enrolled in the nursing program at any one time. The number reflects the capacity of the nursing program based on demonstrated resources sufficient to implement the curriculum.
(29)"Methods of Instruction" means the planned process through which teacher and student interact with selected environment and content so that the response of the student gives evidence that learning has taken place. It is based upon stated course objectives and outcomes for learning experiences in classroom, laboratory, simulation and clinical settings.
(30)"National Credentialing Body" means a credentialing body that offers certification or re-certification in the licensed nurse's or Advanced Practice Registered Nurse's specialty area of practice.
(31)"NCLEX-PN™" means the National Council Licensure Examinations for Practical Nurses.
(32)"NCLEX-RN™" means the National Council Licensure Examinations for Registered Nurses.
(33)"Nursing Accreditation body" means a national nursing accrediting body, recognized by the United States Department of Education.
(34)"Nursing program faculty" means individuals employed full or part-time by academic institution responsible for developing, implementing, evaluating and updating nursing curricula.
(35)"Nursing project" means a project or research study of a topic related to nursing practice that includes a problem statement, objectives, methodology and summary of findings.
(36)"Participating in" means to have a part in or contribute to the elements of the nursing process.
(37)"Pattern of noncompliance" means episodes of recurring non-compliance with one or more Rules in Section .0300.
(38)"Preceptor" means a registered nurse at or above the level of licensure that an assigned student is seeking, who may serve as a teacher, mentor, role model and supervisor for a faculty directed clinical experience.
(39)"Prescribing Authority" means the legal permission granted by the Board of Nursing and Medical Board for the nurse practitioner and nurse midwife to procure and prescribe legend and controlled pharmacological agents and devices to a client in compliance with Board of Nursing rules and other applicable federal and state law and regulations.
(40)"Program Closure" means to cease operation of a nursing program.
(41)"Program" means a course of study that prepares an individual to function as an entry-level practitioner of nursing. The three "Program Types" are:
(a)BSN - Curriculum components for Bachelor of Science in Nursing provides for the attainment of knowledge and skill sets in the current practice in nursing, nursing theory, nursing research, community and public health, health care policy, health care delivery and finance, communications, therapeutic interventions and current trends in health care. For this program type, the client is the individual, family, group, and community.
(b)Associate Degree in Nursing (ADN)/Diploma in Registered Nursing - Curriculum components for the ADN/Diploma in Registered Nursing provides for the attainment of knowledge and skill sets in the current practice in nursing, community concepts, health care delivery, communications, therapeutic interventions and current trends in health care. For this program type, client is the individual, group of individuals, and family.
(c)Practical Nurse Diploma - Curriculum prepares for providing direct nursing care under the supervision of a registered nurse or other health care provider as defined by the Nursing Practice Act. Curriculum components provide for the attainment of knowledge and skill sets in the current practice of practical nursing, communications, therapeutic interventions, including pharmacology, growth and development, and current trends in health care. For this program type client is the individual or group of individuals.
(42)"Review" means collecting and analyzing information to assess compliance with Section .0300 of this Chapter. Information may be collected by multiple methods, including review of written reports and materials, on-site observations,review of documents, andin-person or telephone interview(s) and conference(s).
(43)"Rescind Approval" means a Board action that removes the approval status previously granted by the Board.
(44)"Self-Assessment" means the process whereby an individual reviews her or his own nursing practice and identifies the knowledge and skills possessed as well as those skills to be strengthened or acquired.
(45)"Simulation" means a technique, not a technology, to replace or amplify clinical experiences with guided experiences that evoke or replicate substantial aspects of the real world of nursing practice in a fully interactive manner.
(46)"Specialty" means a broad, population-based focus of study encompassing the common health-related problems of a particular group of patients and the likely co-morbidities, interventions, and responses to those problems.
(47)"Supervision" means the provision of guidance or direction, evaluation, and follow-up by a licensed nurse to accomplish an assigned or delegated nursing activity or set of activities.
(48)"Survey" means an on-site visit for the purpose of gathering data in relation to reviewing a nursing program's compliance with Section .0300 of this Chapter.